South Carolina Legislature Passes Ban on Gender Affirming Care for Transgender Youth; Virginia Poised to be the Sole Refuge For Care in the South

by Delphine Luneau

Ban on Medically Necessary Care Comes Amidst Community and Business Opposition

COLUMBIA, SC—Today, the South Carolina Senate voted to ban access to gender affirming care for transgender youth, including a requirement that youth who have been receiving gender affirming care must cease by January. If signed, the new law would also prohibit public funds from being used to provide this medically necessary, best practice care for transgender people of all ages. Medical professionals would face felony criminal penalties as well as civil liability, removing South Carolina as one of the last two southern states to provide care for trans and gender non-conforming youth. Already living under a national state of emergency, this bill exacerbates existing dangers for and strips care from thousands of LGBTQ+ South Carolinians.

By passing this discriminatory, anti-transgender bill, legislators have put the safety and well-being of South Carolina residents at risk, likely forcing some families to consider leaving the state out of necessity for their health and safety. In a 2023 survey from the Human Rights Campaign Foundation, 42.9% of LGBTQ+ adults said they would move or try to move to a different state if the state were to pass or enact a ban on gender affirming care.

Legislators also risk brain drain, damaging the state's economy and discouraging new businesses and talent from settling in South Carolina. Anti-LGBTQ+ legislation has been opposed broadly by the business community — more than 300 major U.S. corporations have spoken out to oppose discriminatory legislation being proposed in states across the country. In addition, over 100 large employers have also signed onto the Count Us In pledge, which includes a commitment to ensure access to health care for their transgender and nonbinary employees. This new legislation threatens to upend businesses' efforts to attract and retain talent and create a hostile environment for their consumer bases.

Human Rights Campaign Senior Director of Legal Policy Cathryn Oakley shared the following statement:

“South Carolina legislators abused their power today by substituting their judgment for that of parents, medical professionals, mental health care professionals and other experts. This is a major violation of South Carolinians’ liberty. Every credible medical organization in the nation supports age-appropriate gender affirming care, which can be a life-saving treatment for LGBTQ+ youth. These decisions must remain in the hands of medical professionals and parents, not politicians. Governor McMaster should stand on the side of the business community, medical professionals, and the vast majority of his own constituents, reject this extremism, and veto this hateful bill.”

THE FACTS: Gender-Affirming Care

Every credible medical organization – representing over 1.3 million doctors in the United States – calls for age-appropriate gender-affirming care for transgender and non-binary people. “Transition-related” or “gender-affirming” care looks different for every transgender and non-binary person. Parents, their kids, and doctors make decisions together, and no medical interventions with permanent consequences happen until a transgender person is old enough to give truly informed consent.

This is why majorities of Americans oppose criminalizing or banning gender affirming care. Two recent national surveys report that majorities of Americans oppose “criminalizing” or “banning” gender transition-related medical care for minors: 54% oppose (NPR/Marist on 3/20-23, 2023); 53% oppose (Grinnell College National Survey on 3/14-19, 2023). Democrats and Independents drive opposition to such legislation, suggesting that support for such bans carries risk in a general election context.

Gender transition is a personal process that can include changing clothes, names, and hairstyles to fit a person’s gender identity. Some people take medication, and some do not; when a person is able to give mature, informed consent some people have surgeries, and others do not. How someone transitions is their choice, to be made with their family and their doctor. Therapists, parents and health care providers work together to determine which changes to make at a given time that are in the best interest of the child. In most young children, this care can be entirely social. This means:

  • New name

  • New hairstyle

  • New clothing

  • None of this care is irreversible.

Being transgender is not new. Some say it can feel like being transgender is very new – but that’s because the media has been covering it more in recent months and years. But transgender people have always existed and will continue to exist regardless of the bills we pass. And very few transgender people change their mind.

ALL gender-affirming care is age-appropriate, medically necessary, supported by all major medical organizations, made in consultation with medical and mental health professionals AND parents. And in many cases, this care is lifesaving: A recent study from the Trevor Project provides data supporting this — transgender youth with access to gender-affirming hormone therapy have lower rates of depression and are at a lower risk for suicide.

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The Human Rights Campaign is America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer people. HRC envisions a world where LGBTQ+ people are embraced as full members of society at home, at work and in every community.

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